Overdose Response Team Community Referral Form

The goal of the Overdose Response Team is to connect with individuals who are struggling with substance use disorder and have recently experienced or are at high-risk for experiencing an overdose. Through the program, clients and their households are given the opportunity to meet with a Peer Support Specialist and/or a Licensed Master Social Worker, receive and be trained on how to use Narcan, and ultimately discuss harm reduction, treatment, and recovery services that are available to them.

If you are interested in learning more about how our team can help, please complete the form below and someone will reach out within 1-3 business days.

The information provided on this form must be your own. You may not complete this form on behalf of another person.

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Name: *
Zip Code: *
Phone Number: *
Email Address:
Preferred Method of Contact: *
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How were you referred to Recovery Resource Council: *
By completing this form you agree the information provided is your own. You may not complete this form on behalf of another party.
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I give Recovery Resource Council permission to contact me. *
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